Simple Corrective Surgery

New Hope

Two separate reports by scientists at the New York-Presbyterian Hospital's Weill Cornell Medical Center tell us more about male infertility, giving new hope to infertile couples. The first report shows that one of the most common causes of male infertility, varicoceles or varicose veins in the scrotum, cause a depletion of testosterone. The second report demonstrates that when varicoceles are removed by surgery, testosterone levels are restored, along with male fertility.

The author of this study is Dr. Marc Goldstein, Professor of Urology and Reproductive Medicine at Weill Cornell Medical College and attending urologist at NewYork-Presbyterian/Weill Cornell. Dr. Goldstein presented his research at the 2007 annual meeting of the American Society for Reproductive Medicine (ASRM) in Washington, D.C. Goldstein, who received the Howard and Georgeanna Jones Life Time Achievement Award at the convention said, "People often forget or often don't realize that the testes have two purposes. One is the production of the sex cells (sperm), and the other is to produce testosterone."

Dr. Goldstein started his study with the theory that varicoceles cause a significant decrease in testosterone levels. Once Goldstein verified his hypothesis, the next step was to observe whether simple varicocele removal could restore testosterone levels to normal. The researcher found that postsurgical levels of testosterone rose up to 100 percent in two-thirds of the study subjects.

Andropausal Men

Impaired testosterone production may lead males to experience andropause, which can be compared to menopause in women. Andropause brings with it a lowered sex drive, erectile dysfunction, a lessening of muscle strength, lowered energy level, and even depression. Not unlike menopausal women, andropausal men are prone to osteopenia and osteoporosis.

Varicoceles can be hereditary and are found in 15 percent of all males. As the varicoceles become enlarged, they wind themselves around the male testes, causing lowered testosterone production. The condition also leads to lowered sperm counts and poor quality sperm.

It is estimated that 35 percent of all cases of infertility during a first pregnancy attempt (primary infertility) and 80 percent of failed attempts at pregnancy following an earlier successful attempt (secondary infertility) can be attributed to varicoceles. These varicose veins tend to form at puberty and most doctors don't screen their patients for them during routine visits.

Dr. Goldstein is considered a pioneer in urology surgery and he contributed to the creation of the microsurgery procedure that is now the standard for the treatment and removal of varicoceles.